ACCME/AMA Glossary of Terms and Definitions

[Pages:10]Accreditation Council for Continuing Medical Education (ACCME?) and American Medical Association (AMA) Glossary of Terms and Definitions

ACCME Recognized Accreditors

State and territory medical societies recognized by the ACCME as accreditors of intrastate CME providers. To achieve recognition, a state or territory medical society must meet the ACCME requirements, the Markers of Equivalency.

Accreditor

An organization that sets and enforces the standards for CME provider organizations and/or activities through review and approval of organizations/activities, and monitors and enforces guidelines for these organizations/activities.

Accreditation

The framework by which a program of CME is assessed to determine whether the program meets the accreditor's requirements. See also "Accredited CME provider."

Accreditation criteria

The requirements against which CME providers' compliance is determined in order to achieve or maintain accreditation.

Accreditation decision

The decisions made by an accreditor concerning the accreditation status of CME providers. In the ACCME System,, there are five options for accreditation status: Provisional Accreditation, Accreditation, Accreditation with Commendation, Probation, and Nonaccreditation.

Accreditation interview

A step in the accreditation and reaccreditation process. In the ACCME System,, volunteer surveyors review the CME provider's self-study report and performance-in-practice files, and then meets with the provider for the interview portion of the reaccreditation process. The purpose of the interview is for the provider to explain how the CME program fulfills accreditation requirements, and to discuss its strengths, accomplishments, and challenges.

Accreditation Review Committee (ARC)

The ACCME volunteer committee that reviews and analyzes the materials submitted by CME providers and surveyors to determine providers' compliance with the ACCME Accreditation Criteria and policies. Based on this review, the ARC makes recommendations about accreditation decisions to the ACCME Decision Committee.

Accreditation statement

The standard statement that must appear on all CME activity materials and brochures distributed by ACCME-accredited providers. There are two variations of the statement; one for directly provided activities and one for jointly provided activities.

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Accreditation with Commendation

The highest accreditation status available in the ACCME System,, accompanied by a six-year term of accreditation; available only to providers seeking reaccreditation, not to initial applicants.

Accredited CME

The term used to refer to continuing medical education that has been deemed to meet the requirements and standards of a CME accrediting body.

Accredited CME provider

An organization accredited as a provider of continuing medical education. Accredited CME providers assume the responsibility and accountability for developing certified educational activities. ACCME-accredited providers represent a range of organizational types and offer CME primarily to national or international audiences of physicians and other health care professionals. Intrastate-accredited providers offer CME primarily to learners from their state/territory or contiguous states.

Activity

See "CME activity."

Activity review

One of the ACCME requirements for achieving Provisional Accreditation or transitioning from Provisional Accreditation to Accreditation.

Advertising and exhibits income

Advertising and exhibits are promotional activities and not continuing medical education. Therefore, monies paid by commercial interests to providers for these promotional activities are not considered to be commercial support under the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities .SM

AMA core requirements

The AMA requirements that every activity certified for AMA PRA Category 1 CreditTM must meet. They can be found in the AMA PRA booklet.

AMA Credit Designation Statement

The statement that indicates that the activity has been certified for AMA PRA Category 1 CreditTM, and includes the type of activity and number of credits.

AMA Direct Credit Activities

Activities that do not occur under the auspices of an accredited CME provider and for which the AMA directly awards credit to physicians who meet the requirements as listed in the AMA PRA booklet.

AMA House of Delegates

The principal policy-making body of the AMA. This democratic forum represents the views and interests of a diverse group of member physicians who meet twice per year, to establish broad policy on health, medical, professional and governance matters, as well as the broad principles within which the AMA's business activities are conducted.

AMA Physician's Recognition Award (PRA)

The AMA PRA has recognized physician participation in CME since 1968. The AMA established the PRA certificate and the related AMA PRA credit system to recognize physicians who, by participating in CME activities, demonstrate their commitment to staying current with advances in medicine. More information can be found in the AMA PRA booklet.

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AMA PRA Category 1 CreditTM

The type of CME credit that physicians earn by participating in certified activities sponsored by CME providers accredited by either the ACCME or an ACCME-recognized State/Territory Medical Society; by participating in activities recognized by the AMA as valid educational activities and awarded directly by the AMA; and by participating in certain international activities recognized by the AMA through its International Conference Recognition Program.

AMA PRA Category 2 CreditTM

Credit that is self-claimed and self-documented by physicians by participating in activities that are not certified for AMA PRA Category 1 CreditTM and that the physician individually determines comply with the AMA definition of CME; and comply with the relevant AMA ethical opinions (see CEJA Opinions relevant to CME); and are not promotional; and the physician finds to be a worthwhile learning experience related to his/her practice.

AMA PRA CME credit system

Developed in 1968, the credit system initially described the type of educational activities that would qualify to meet the requirement to obtain the AMA's PRA (See Physician's Recognition Award). The AMA PRA Standards and Policies have evolved and now AMA PRA credit has been accepted as an educational metric for the purposes of state licensure, professional credentialing, hospital privileging and maintenance of certification of physicians.

Annual Report Data

Data that accredited providers are required to submit to the ACCME on at least an annual basis describing their overall CME program. This information includes summary data about the numbers and types of CME activities, the hours of instruction, the numbers of physician and other learner participants, and some financial information. The ACCME analyzes this data to monitor changes in individual CME programs as well as to assess trends across the CME enterprise. Each year, the ACCME publishes the aggregated information, offering a comprehensive analysis of the size and scope of the CME enterprise nationwide.

Certified CME

Nonpromotional learning activities certified for credit prior to the activity by an organization authorized by the credit system owner, or nonpromotional learning activities for which the credit system owner directly awards credit.

CME activity

An educational offering that is planned, implemented, and evaluated in accordance with the ACCME Accreditation Criteria, Standards for Commercial Support, and policies; the AMA Physician's Recognition Award CME credit system standards and policies; and the AMA Council on Ethical and Judicial Affairs pertinent opinions.

CME credit

The "currency" assigned to CME activities. Physicians and other healthcare professionals use credits to meet requirements for maintenance of licensure, maintenance of specialty board certification, credentialing, membership in professional societies, and other professional privileges. The requirements for credit designation are determined by the organization responsible for the credit system. Besides the AMA, other organizations in the US that administer credit systems for physicians include the American Academy of Family Physicians and the American Osteopathic Association. Please refer to those organizations for more information. See AMA PRA Category 1 CreditTM and AMA PRA Category 2 CreditTM above.

Commercial bias

Content or format in a CME activity or its related materials that promotes the products or business lines of an ACCME-defined commercial interest.

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Commercial interest

Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests. A commercial interest is not eligible for ACCME accreditation or participation in joint providership.

Commercial support

Monetary or in-kind contributions given by an ACCME-defined commercial interest that is used to pay all or part of the costs of a CME activity. The requirements for receiving and managing commercial support are explained in the ACCME Standards for Commercial Support. Advertising and exhibit income are not considered commercial support.

Committee for Review and Recognition (CRR)

The ACCME volunteer committee that collects, reviews, and analyzes data about Recognized Accreditors' (state or territory medical societies) compliance with the ACCME's recognition requirements, the Markers of Equivalency. through a process called Maintenance of Recognition. The CRR makes recognition recommendations to the ACCME Decision Committee. See also "Maintenance of Recognition."

Committee learning

A live CME activity that involves a learner's participation in a committee process addressing a subject that would meet the ACCME definition of CME if it were taught or learned in another format.

Competence

In the context of evaluating effectiveness of a CME activity in the ACCME System, the extent to which learners know how to implement (or stop doing) what the activity intended to teach them.

Compliance

The finding given when a CME provider has fulfilled the ACCME's/Recognized Accreditor's requirements for the specific criterion in the Accreditation Criteria or policy.

Conflict of interest

The ACCME considers financial relationships to create conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest. The potential for maintaining or increasing the value of the financial relationship with the commercial interest creates an incentive to influence the content of the CME--an incentive to insert commercial bias. See also "relevant financial relationships."

Continuing Medical Education (CME)

The educational activities that serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships a physician uses to provide services for patients, the public, or the profession. CME represents that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public.

Continuing Professional Development (CPD), or Continuing Physician Professional Development (CPPD)

Includes all activities that doctors undertake, formally and informally, including CME, in order to maintain, update, develop, and enhance their knowledge, skills, and attitudes in response to the needs of their patients.

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Co-provided activity

A CME activity presented by two or more accredited providers. One of the accredited providers must take responsibility for the activity in terms of meeting ACCME and AMA requirements and reporting activity data to the ACCME. See also "directly provided activity."

Council on Ethical and Judicial Affairs (CEJA)

The AMA elected body responsible for developing ethics policy for the AMA. Comprising seven practicing physicians, a resident or fellow, and a medical student, CEJA prepares reports that analyze and address timely ethical issues that confront physicians and the medical profession. CEJA maintains and updates the AMA Code of Medical Ethics, widely recognized as the most comprehensive ethics guide for physicians. In addition, CEJA has judicial responsibilities, which include appellate jurisdiction over physician members' appeals of ethics-related decisions made by state and specialty medical societies. To protect the integrity and quality of the CME enterprise and to support the autonomy of physicians as voluntary participants in CME activities, CEJA has rendered Opinions 9.2.6, Ethical Issues in CME; 9.2.7, Financial Relationships with Industry in Continuing Medical Education; and 9.6.2, Gifts to Physicians from Industry. Activities certified for AMA PRA Category 1 CreditTM must be developed in accordance with these opinions.

Council on Medical Education

The AMA elected body that formulates policy on medical education (including undergraduate, graduate, and CPPD/CME) by recommending educational policies to the AMA House of Delegates, through the AMA Board of Trustees. The Council provides stewardship of the AMA PRA credit system, and is also responsible for recommending nominees to the boards of ACCME and other accrediting bodies, as well as to other national organizations.

Course

A live CME activity where the learner participates in person. A course is planned as an individual event. Examples: annual meeting, conference, seminar.

Designation of CME credit

The declaration that an activity meets the requirements for a specific type of credit. The accredited provider is responsible to those organizations that administer credit systems for compliance with applicable credit requirements. Note: The designation of credit for CME activities is not within the purview of the ACCME or ACCME Recognized Accreditors. See also "CME credit."

Directly provided activity

One that is planned, implemented, and evaluated by the accredited CME provider. This definition includes co-provided activities (offered by two accredited providers) reported by the accredited provider that awards the credit.

Documentation review

See "performance-in-practice review."

Enduring material

An activity that endures over a specified time and does not have a specific time or location designated for participation; rather, the participant determines whether and when to complete the activity. Examples: online interactive educational module, recorded presentation, podcast.

Faculty

The individuals responsible for teaching, authoring, or otherwise communicating the activity content to learners.

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Financial relationships

See "relevant financial relationships."

Focused accreditation interview

A specially arranged interview between the ACCME/Recognized Accreditor and an accredited provider to address noncompliance areas that had been identified in an accreditation review or had not been corrected in a progress report.

Hours of instruction

Hours of instruction represents the total hours of educational instruction in a CME activity. The information is used for the purpose of reporting the activity in PARS. (See PARS below.) For example, if a one-day course lasts eight hours (not including breaks or meals), then the total hours of instruction reported for that course is eight. Hours of instruction may or may not correspond to the number of AMA PRA Category 1 CreditsTM for which the activity is designated.

In-kind commercial support

In the context of the ACCME's Standards for Commercial Support, non-monetary resources provided by a commercial interest in support of a CME activity. Examples of in-kind support include equipment, supplies, and facilities.

Internet enduring material activity

An enduring material provided via the Internet, meaning that there is no specific time designated for participation. Rather, the participant determines when to complete the activity. Examples: online interactive educational module, recorded presentation, podcast.

Internet live activity

A live course available via the Internet at a certain time on a certain date and is only available in real-time, just as if it were a course held in an auditorium. Example: webcast.

Internet Point of Care (PoC) learning (Internet searching and learning)

An activity in which a physician engages in self-directed, online learning on topics relevant to their clinical practice from a database whose content has been vetted by an accredited CME provider.

Intrastate accredited provider

See "Accredited CME provider."

Jointly provided activity

An activity that is planned, implemented, and evaluated by an accredited provider and one or more non-accredited entities.

Journal-based CME

An activity that is planned and presented by an accredited provider and in which the learner reads one or more articles (or adapted formats for special needs) from a peer-reviewed, professional journal.

Knowledge

In the context of educational needs for a CME activity in the ACCME System,, the extent to which learners have a need for new information.

Learner

An attendee at a CME activity. See also "physician learners," and "other learners."

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Learning from teaching

Personal learning projects designed and implemented by the learner with facilitation from the accredited provider. It recognizes the learning that occurs as physicians prepare to teach.

Live activity

Activity that occurs at a specific time as scheduled by the accredited CME provider. Participation may be in person or remotely as is the case of teleconferences or live internet webinars.

Maintenance of Recognition

ACCME system to ensure that Recognized Accreditors are applying the national standards for accreditation decisions and the accreditation process. Recognized Accreditors submit documents and information on an ongoing basis. The ACCME provides detailed, formative feedback to Recognized Accreditors in real time as the data is reviewed. Feedback is given in relation to the Markers of Equivalency. The ACCME adopted Maintenance of Recognition in 2011 in order to improve the quality, value, and efficiency of the recognition process and to enable the ACCME and Recognized Accreditors to identify areas for improvement on an ongoing basis.

Manuscript review activity

Activity in which a learner participates in the critical review of an assigned journal manuscript during the pre-publication review process of a journal.

Monitoring

The ACCME monitors accredited providers between formal accreditation reviews by reviewing the program and activity data they submit on at least an annual basis. In addition, the ACCME and AMA each have a formal procedure for accepting and reviewing complaints from the public and the CME community about accredited providers' compliance with accreditation and credit system requirements.

New procedures and skills training

Activity whereby accredited CME providers can train physicians on topics that may allow them to request new or expanded clinical privileges. The AMA PRA framework for new skills and procedures training consists of four levels so that accredited CME providers and physicians can clearly identify the depth and complexity of the training.

Nonaccreditation

The accreditation decision by the ACCME/Recognized Accreditor that a CME provider has not demonstrated compliance with the appropriate ACCME requirements.

Noncompliance

The finding given by the ACCME/Recognized Accreditor when a CME provider does not fulfill the ACCME's requirements for the specific criterion in the Accreditation Criteria or policy.

Other learners

Learners other than those who have obtained an MD, DO, or equivalent medical degree from another country.

Parent organization

An outside entity, separate from the accredited provider, that has control over the accredited provider's funds, staff, facilities, and/or CME activities.

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Performance

In the context of evaluating effectiveness of a CME activity in the ACCME system, the extent to which learners do what the CME activity intended them to be able to do (or stop doing) in their practice.

Performance Improvement CME (PI CME)

An activity structured as a three-stage process by which a physician or group of physicians learn about specific performance measures, assess their practice using the selected performance measures, implement interventions to improve performance related to these measures over a useful interval of time, and then reassess their practice using the same performance measures.

Performance-in-practice review

During the initial accreditation, reaccreditation, and progress report processes, the ACCME/Recognized Accreditor selects activities to review from the CME provider's current accreditation term. The provider then submits materials documenting how these activities fulfilled accreditation requirements. This process enables the ACCME/Recognized Accreditor to ensure that accredited providers are consistently complying with requirements on an activity level.

Physician learners

Activity learners who are MDs or DOs, or have an equivalent medical degree from another country.

Probation

Accreditation status given by the ACCME/Recognized Accreditor to accredited providers that have serious problems meeting ACCME requirements. Probation may also be given to providers whose progress reports are rejected. The accredited provider must correct the noncompliance issues in order to return to a status of Accreditation.. While on probation, a provider may not jointly provide new activities. See also "progress report."

Program of CME

The provider's CME activities and functions taken as a whole.

Progress Report

Accredited providers that receive noncompliance findings in the Accreditation Criteria or policies must submit a progress report to the ACCME/Recognized Accreditor demonstrating that they have come into compliance. If the accredited provider successfully demonstrates compliance, the progress report is accepted and the provider can then complete its accreditation term. If the progress report does not yet demonstrate compliance, the accredited provider will be required to submit a second progress report and/or the ACCME may require a focused accreditation interview to address the areas of noncompliance. The ACCME/Recognized Accreditor can also place an accredited provider on Probation or issue a decision of Nonaccreditation after reviewing a progress report.

Program and Activity Reporting System (PARS)

A web-based portal from the ACCME designed to streamline and support the collection of program and activity data from accredited CME providers. PARS is also used by accredited providers to register CME activities that will count for Maintenance of CertificationTM and other uses, such as the Food and Drug Administration's Risk Evaluation and Mitigation Strategies (REMS).

Provider

See "Accredited CME provider."

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